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Clinical appearance:
Signs typically follow closely (average 2 days) after the inciting event. Patients often present first for pain over the dorsum. The discomfort may be severe enough
to mimic trauma or disk herniation. Within one or two days, patients typically develop a papular eruption on the dorsum, which quickly evolves into furuncles and deep draining tracts. Patients may become depressed with evidence of systemic involvement or may appear otherwise well.
Diagnosis:
The peracute appearance of dorsally distributed pain followed by the rapid development of furuncles in a patient with a history of recent bathing or water exposure is extremely suggestive. Differential diagnoses would include disk herniation or spinal trauma (if seen before the cutaneous lesions develop), demodicosis, pustular dermatophytosis, drug eruption, SJS/TEN and chemical or thermal burns. In contrast to “typical” bacterial furunculosis, the causative organism here is typically Pseudomonas aeruginosa, although other organisms may also be present. Cytology may demonstrate gram negative bacteria, with or without concurrent gram positive cocci. Skin scrapings and dermatophyte cultures will be negative. Biopsy will demonstrate furunculosis and cellulitis, with or without intralesional bacteria.
Therapy:
Prompt aggressive analgesic and antibiotic therapy (typically with fluoroquinolones) is absolutely essential. Severely affected animals may require hospitalization and more advanced supportive fluid therapy. A complete blood count, chemistry profile and urinalysis are appropriate, both to evaluate for possible systemic involvement and to provide a baseline for therapeutic monitoring. Blood cultures may be warranted in severely affected animals.
The prognosis for post-grooming furunculosis is generally considered to be very good, with most animals demonstrating improvement within 24-48 hours. However, individual case may take longer to respond. Although unusual, sepsis and death have been reported.
An Urban Experience
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